250 Table 10.1 MRI characteristics of adenomyosis: Objective Adenomyosis MRI Features, based on (181): MRI Feature Definition Unit Stratification Average Junctional Zone thickness (AJZ) Mean of JZ measurement at 6 points of the uterus: Fundus, Mid-corpus, Isthmus, measuring the anterior and posterior wall at each point in the mid-sagittal plane. Mm >7mm, >10mm, >12mm Maximal Junctional Zone Thickness (JZMax) Maximal diameter of JZ from those measured at the 6 points as described above, with location Mm >7mm, >10mm, >12mm Minimal Junctional Zone Thickness (JZMin) Minimal diameter of JZ from those measured at the 6 points as described above Mm Junctional Zone Differential (JZDiff) As a measure of JZ irregularity Difference between maximal and minimal JZ Mm >5mm Junctional Zone Asymmetry (JZAsymm) Difference between anterior and posterior JZ (based on measurement at 6 points previously described) Mm Junctional Zone to Myometrium Ratio (JZ/Myo Ratio) Ratio of Junctional zone to full myometrium thickness (measured at 6 points previously described) % >40% Uterine volume Uterine length x width x height x 0.523 (146). The length of measured in the sagittal plane from the outer ostium of the cervix until the fundus. Width was measured in the axial plane, and height in the transverse plane at the mid-corpus. Mm3 Average Uterine Wall Thickness Uterine wall thickness measured from endometrium to myometrium, at 6 points previously described Mm Adenomyotic foci volume Volume of adenomyotic foci in 3 orientations Calculated using the formula of a sphere: 4/3.T. U^3 Mm3 <40mm3, 40-60 mm3, > 60 mm3 (Number of) HSI adenomyotic foci (Myometrial Cysts) Visible high signal intensity (HSI) myometrial foci (compared to normal myometrium) on T1 or T2weighted imaging* >5 Adenomyosis Signal intensity ratio (SIR) Signal intensity ratio of adenomyotic tissue compared to that of the rectus muscle on T2 imaging (as measured using Region of Interest (ROI) circles). *on the total MRI scan, not per image slice. Duplicate counting foci in various slices was avoided by tracking lesions across slices using the localisation cursor.
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